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Lung volume reduction surgery showing clinically significant effects

Royal Brompton and Harefield NHS Foundation Trust pioneered surgical lung volume reduction surgery; an operation aimed at removing the worst affected areas of the lung, and performed one for the first randomised controlled trial in the field.

Early results were associated with high mortality suggesting a need to improve the procedure which the chronic respiratory failure research team did by showing that bronchoscopic lung volume reduction was feasible, could improve exercise performance and when associated with atelectasis, could potentially improve survival.

Based on this data funding was successfully obtained from NIHR to perform a randomised controlled trial which has now been completed demonstrating clinically significant results and is likely to lead to widespread adoption of this technique.

The research team also demonstrated that the surgical approach to lung volume reduction in emphysema is safer in current clinical practice, especially considering the use of a multidisciplinary team, than in historic trials which suggests that it should be more widely adopted. This has been supported by a survey the Trust we carried out on behalf of the British Thoracic Society showing that respiratory clinicians often have an exaggerated view of the risks associated with the procedure.